Individual provider Active NPI

Rex Beach Perkins III, LICSW

  • Clinical Social Worker
  • Tuscaloosa, AL
National Provider Identifier
1114575768
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3951C Issued in AL
Practice address
1050 Lurleen B Wallace Blvd S
Tuscaloosa, AL 35401-2219
Phone
(205) 861-0317
NPI assigned
Aug 27, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3951C AL Primary

Addresses

Primary practice location

1050 Lurleen B Wallace Blvd S
Tuscaloosa, AL 35401-2219

Mailing address

1050 Lurleen B Wallace Blvd S
Tuscaloosa, AL 35401-2219
Phone (205) 861-0317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3951CALMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1114575768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 LURLEEN B WALLACE BLVD S",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012219",
            "telephone_number": "205-861-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LURLEEN B WALLACE BLVD S",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012219",
            "telephone_number": "205-861-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "REX",
        "middle_name": "BEACH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3951C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.